Wednesday, September 30, 2009
Tuesday, September 29, 2009
If I do get into pharmacy school, I will promptly go and get my first tattoo. It is a Bowl of Hygeia I have been designing the last couple years. Obviously I will not get something like that unless I am sure I will be in pharmacy for the long haul.
My prized possession is the one which my wife does not like. In fact, it currently resides in the closet of our study. To be honest, I understand that. It's more of a single guy's pad type of thing, but I still think it's cool. Besides, who else honestly has something like this in their home? Probably the best thing I ever found while cleaning out the basement of my work many years ago.
Sunday, September 27, 2009
Here are two examples from this past week alone.
First, I discovered a patient had been given a 90 day supply of Simvastatin 80mg instead of her usual 30 day supply of Simvastatin 20mg. The pharmacist on duty simply put the wrong bottle in the wrong bag. The patient is about 93 years old and really didn't put two and two together. I figured it out when she called in that particular refill number on the incorrect bottle. She also mentioned she started having random muscle pain in the last month. Oh joy.
Second, a patient came in asking if we could verify the dose on her husband's Vitamin D prescription. I looked it up and it was indeed filled wrong. The prescription was written for 1,000 IU per day. Someone had filled it for 50,000 IU per day. The patient had been taking those dose for six months. Lovely.
Now does this happen elsewhere? Seems as if this kind of thing happens on a semi-regular basis around here, moreso in the last few months, and the pharmacists are rather apathetic about it.
Or am I just being overly cautious because it seems to me that there is something massively wrong with both our pharmacists and the way we fill things here. I can't wait to get the hell outta here.
Monday, September 21, 2009
The test was supposed to take around two hours or so if I remember correctly. I remember breezing through it in about a half hour seeing as I had already had four years of experience at that point. What I do remember is the test being challenging in certain areas, especially the questions regarding drugs. I remember a good deal was based on hospital protocol and there were only a few math based questions.
When I passed, it was one of the largest achievements I had made at that point in my life.
Today, though, it seems like any dimwit can earn certification from the PTCB. About a year ago a new employee, whom had never worked in a pharmacy before and even admitted to not know what hydrocodone was the day before the test, decided to take the PTCE after working for us for a week.
I laughed it off thinking, there's no way in hell he'll pass that.
But he did.
And I started reading more about what the test had become in the years since I took mine. I found out that it was now computer based and stopped once you correctly answered enough questions. And you could take it locally now which woulda been a helluva lot nicer than getting up at 4 in the morning.
Yet I keep reading again and again about how people are becoming certified when they know nothing about pharmacy. Most read through one of the review books in a week and go take the test and then pass.
First I should mention I do not support the 'tech schools' out there that train people for this job. I think its a waste of money personally because you're essentially paying to learn on the job training, but whatever that's an argument for another post.
However I do not think it's right that someone can earn this designation and not know a damn thing about pharmacy. From what I have gathered the test has become more math based and the questions regarding drugs are insanely easy. Which makes sense when I read about some of the yahoos that are now certified.
What happened to the honor it was to carry the title C.PhT after your name? It used to be that when we hired someone and they were certified, you knew that they knew their shit. Now it doesn't mean a damn thing as they can be as big of an imbecile as any other green tech.
It just seems like there should be some sort of reform here ya know? Maybe actually challenge people a bit? Am I the only one who's noticed this?
Sunday, September 20, 2009
I was getting caught up on Old MD Girl's blog when I decided to go through her blog roll. The very first post I read contained one of the most emotional pieces I have found yet on the various medical blogs.
Those of you who just read these, and not write them, may not understand the difficulty in expressing the circumstances of your day. It seems easy, at first, but as time goes on it becomes increasingly difficult.
Now one of the things I have tried to do here is emphasize the passion for pharmacy and the medical fields in general. Judging from how this blog has been reviewed in various places, it seems I have succeeded to a certain degree. Yet it is always difficult to write an eloquent post that can relay feelings accurately.
Today I present to you a post like that. A post which explains why I am choosing a career in the medical fields. A post which explains what a lot of his feel on a regular basis. A post which should remind those who have become disillusioned what we are here for.
I present I Care from the blog 6YearMed
Friday, September 18, 2009
I decided to take a few days off from pumping out applications to get caught up on a few of the larger forums out there. After a while I realized I was rather disgusted with most of them. A lot of the individuals there are extremely conceited and full of themselves.
And I see a lot of you guys come to this blog, so I'll give you a little word of advice.
Pull your fucking head out of your damned ass.
You are not the greatest person in the world because you got a 98 on your PCAT. Just because you chose pharmacy as a career does not justify the fact you think you are better than everyone else. You're really no different than anyone else in the medical fields.
And don't talk down to someone with a lower GPA than yourself. Sure, you got a 4.0, but that doesn't mean you're smarter than the kid who got a 3.0. There are extenuating circumstances that prevents some from reaching their full potential in college. Many don't have mommy and daddy's money to fall back on when times are rough.
The cockiness needs to go as well. So you have your 98 PCAT score, your 4.0 GPA and you worked at Wal-Mart for a year as a tech or clerk. Whoopdy fuckin' do. I'll give you a little word of advice, you don't learn shit at a place like Wal-Mart. Anyone that has ever transferred to our stores from Wal-Mart could count and that was really about it.
Granted the Tier 2 techs are slightly better, but you still don't know shit. You may be certified, but that test is a fucking joke today anyways (future post coming on that) and it really doesn't mean anything now. A drunk monkey with one eye could pass the exam.
For some reason these people seem to be mainly located in the California region of the country. Damn good thing I'm not applying to any school in that state.
Am I being cruel? No, I'm not. Leave your egos at the door. Stop talking as if you're Superman. Act human for Christ's sake. Is that too much to ask?
Thursday, September 17, 2009
Some want an essay in 1000 words. Some in 1000 characters. Some in 1000 characters with spaces. Some in three pages (whatever the fuck that means as there is no formatting requirements). Rain Man couldn't even keep track of all this shit.
And the questions are so abstract at times its unreal. Or they'll ask you a question that requires a detailed answer, but they want you to keep it under 300 words.
The best part is the same questions appear on the various apps, but they're all just different enough that you have to write a new one.
I was writing a slew of them at about 2am the other night when I realized that I that first I had combined two questions in one answer and then in another I had typed 1700 words when they wanted 1700 characters.
Thank God I'm almost done with these... they're really starting to tap out what's left of my sanity.
Tuesday, September 15, 2009
Until recently that is.
Six months ago we started having to add the 10/325mg strength to the robots. It wasn't that uncommon to see someone switch from #240 of 10/500mg to #360 of 10/325mg. On some days, the 10/325mg flavor was the most used.
Now we've had a rush of scrips for the 5/325mg flavor in the past month. Some docs have exclusively switched from 5/500mg to 5/325mg. We were debating on Thursday whether or not we need to start adding this to the robots as well.
Yesterday someone handed me the first script for 7.5/325mg that I have seen in five years.
What in the hell is going on? What is with the massive change in the past year? I mean I see why they could be going that route as they were previously limited to eight tablets a day so their liver didn't explode. Now they can enjoy upwards of 120mg of hydrocodone daily.
Where is the logic in this? The people who are bringing these in are those who are on narc contracts or are known abusers. Isn't this just catering to their problem?
Is this happening anywhere else or is isolated to the small area here? Is there some therapeutic benefit that we're not aware of or have I figured out the method to this madness? I hope to God I'm wrong because, if so, I'll have even less faith in prescribers than I do already.
Monday, September 14, 2009
I call it the Montgomery Scott Method.
Us nerds know that Montgomery Scott, better known as Scotty, was nicknamed the Miracle Worker on Star Trek. During a cameo on Star Trek: TNG, he explained to someone else how he earned that moniker. His explanation?
If someone asks you do to something, and asks them how long it takes, you never tell them how long it'll really take. If it takes 2 hours say it'll take 3 hours. That way when you get done early, everyone is impressed. If it takes you longer than you thought, you have that extra hour to work with. In either case you'll be looked at as a Miracle Worker.
That really sums it up. When people bring in an Rx and say they're gonna wait and ask how long it'll take I'll tell them 15-20 minutes even though I know it'll take less than five. That way when I bring them their fresh Rx after five minutes they are impressed with how quickly I was able to complete it for them.
I've also used this on projects many many times. One of my old managers thought I was practically a god for how 'quickly' I could get things done.
Is it dishonest? In a small way, yes, but I see no harm in it. Just a little self promotion right?
Friday, September 11, 2009
My cousin and I were chatting a few weeks back and I mentioned I was due to renew my certification for another two years. She quipped back 'What, do you're a Certified Pharmacy Bitch?"
I've been thinking about it and, ya know what, we should have Certified Pharmacy Bitches.
As of today I am sketching out the requirements needed for such certification, but I am more than open to suggestions from the readers of this blog. I figured it can be associated 'unofficially' with the APhA (because that makes me giggle so hard my I pee a little) and I even have the certificate in the works.
As you can see we'll also need a Board of Directors and someone to chair it. Thinking of seeing of TAestP would be interested in lending his name to this new cause.
Either put your thoughts in this post or feel free to email me.
Wednesday, September 9, 2009
So I'm filling in at a store for the day, a store I typically do not work at, and thus far it has been rather uneventful. I decide to take a minute to go replenish my empty Mountain Dew bottle when I see a gentleman sitting in chairs.
He looks familiar, but I can't place him. God that pisses me off when that happens. I ask the clerk if he's waiting, she replies yes, so I go to check the name to satisfy my own curiosity.
I look at the name and it dawns on me on who it is.
Now for a little back history;
A few weeks back we had a script set up for delivery go missing. For whatever reason our clerk had left them on the edge of the counter and went about with the rest of her work. Of course it would have to be a hydrocodone/apap script. At about the same time a guy and his wife show up to pick up some prescription. Noticing the delivery and its location he and his wife devise a fairly sophisticated system to grab the prescription.
Gotta hand it to them, this was one of the most sophisticated, and ballsy, maneuver that I have seen yet. This was in front of other customers and everyone in the pharmacy. Thank God I wasn't working that day.
Anywho we figured out what happened, watched the video and had been working for a week to put together a case against him.
Low and behold the same dude, with his wife, was sitting in chairs. When I looked at the scripts I realized that they were for him, but with a different name and birthday. For hydrocodone and diazepam. And he wanted to pay cash.
Na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, na, Batman!
I exit the pharmacy immediately so he doesn't recognize me as he is a regular at my main store.
I quickly call my manager to let her know of the situation and she is flabbergasted that he would even attempt such a thing after what he did previously. Now we have to figure out if we can confirm that it is actually the same person. I'm only 95% sure it's him, but I don't want to get an innocent man arrested.
So I tell our pharmacist to pull out the HIPPA forms and ask him to see an ID. I watch the pharmacist talk to him over the security cameras, but then the guy and his wife exit the store The RPh comes back and says that he didn't have one on him.
Rats, plan foiled. Or is it?
A few minutes later he strolls back in the store with an ID. An ID with his REAL name on it.
What a fucking dumbass.
I spring in to motion calling 911 and give them the details of the situation. They state they'll send some officers to our location immediately.
Then I notice, for whatever reason, they are letting him leave after paying for the scripts. I grab two co-workers and tell them to go outside by the parking lot and get info on the vehicle they get into. As he leaves, they come back in and tell me what they saw.
I call dispatch back and update them. As I'm relaying all the details the dispatcher goes "And..... we got them, thanks." and then hangs up.
Turns out the guy took about thirty hydrocodone 10/500mg and 20 diazepam 10mg as he was being pulled over. Naturally he OD'd, but they managed to empty his stomach upon arrival at the local hopsital.
He had a few other warrants out as well, so upon being released from the hospital he was tossed in the clink. At least we can find him when we finish our case against him now.
I decided to go to the urgent care, which is just down the road from us, where he had gotten the Rxs to talk to the doc. I wanted to know if there were any other scripts floating out there because this guy obviously had cojones of epic proportion.
When I explained to him the situation he was shocked. Apparently he came in with a neck brace and, what appeared to be, spasms. Then, naturally, he became very pissed off and flagged the hell out of his profile(s) in their system.
The next day we found out that he had pulled the same thing at two other Urgent Cares and had them called into two other pharmacies.
But I foiled his evil plan muhahahahahahhaha.
Seriously what bad luck does this son of a bitch have to come into a store where I just happen to be working. If I hadn't been there, no one would know who he was. That makes me giggle even more.
To top it off, he is the 20th person I have sent to jail in my five year tenure here. I feel like I should get a cake or a gold watch or something.
And they say pharmacy is boring at times...
Tuesday, September 8, 2009
Everyone has their go to for this situation. For daily use, I have the UniWatch blog or perhaps cnet.com. For actual magazines, usually Car and Driver or Maxim.
And then there are those special readings, the ones that you only get once a month or so. I'm not talking about a magazine, but a single article that, when published, you print off and bring with you for when 'the time is right.'
For me those special readings come from Bill Simmons. Those of you who are not into sports or despise ESPN, which is understandable, may have no idea who Bill Simmons is. Quite simply put he is one of the funniest SOBs to pen anything on the net. He could turn the most mundane of situations into high class hilarity.
My readings for the past four days? His return trip to Vegas found in two parts: Part 1 - Part 2
It is just one of those things that literally makes me laugh while I read it. Of course it draws funny stares (especially if you come out of a stall laughing) but its well worth it.
A recent gem from the discussing of creating a Real Men of Genius Hall of Fame
And my friend Wildes thinks we should throw in the first guy who looked at a cow and said "F this, I'm drinking that milk" in a fit of thirsty bestiality. Source
I snorted some horseradish up the ole olfactory area when I read that.
I ask you, oh loyal readers, if you have anything you use for your lunch time/shitter reading. I'm always up for something interesting to kill time.
Monday, September 7, 2009
And I got to thinking, at least once a day I'll see a link that came from someone's inbox. I've always wondered what I did to warrant being e-mailed to another person. Or even what context it was emailed in.
It is really weird to see this blog being emailed across the country considering I just started this as a place to centralize my crazy ass work stories. Hell the last two email related links I've found where to Mexico. I'm international now baby.
Damn, does this mean I have to learn spanish?
Edit: I noticed in the last hour I've had significant hits from two of the pharmacy schools I'm applying to. Interesting....
Sunday, September 6, 2009
* Brake fluid and bleach, when combined, make a shit ton of smoke
* Eating beer and buffalo wings all night long make a sufficient laxative
* Peeing on an electric fence doesn't hurt... touching your penis to that same electric fence does
* Stoners make massively entertaining friends
* People are far more stupid than we give them credit for
* A 600 pound woman can, in fact, find a tube top to stuff herself into
* Sharting is not as rare of a phenomenon as you are lead to believe
* Alcohol can make anything look sexy... including trees
* One of my friends has a fetish for trees when he's drunk. See above
* Lighting farts on fire is possible
* Punching bank windows, when you need more beer money, will lead to a broken hand
* Drunken backflips off of a roof of a car do not end well
* Chemistry is not as useless as it is made out to be
* Slapping a taper on the ass, in a zoo, is NOT a good idea
Some day I'm gonna sit down and write myself a book. Until then, its on to the quarter century mark!
Saturday, September 5, 2009
*Note that total was based off the AWP of Viagra 100mg as of the date of this post
I find it kind of funny how the news can be flooded when our president swats a fly, but when the largest pharmaceutical company in the world is fined $2.3 billion for lying to the American people, no one cares.
In what authorities called the largest criminal fine in history, pharmaceutical giant Pfizer Inc. has agreed to pay $1.3 billion, plus $1 billion in civil penalties, for peddling drugs to treat conditions for which the federal government had not approved the medications. Source
Now I knew Pfizer had been spanked by the FDA this year, but I had not realized they were spanked that hard. Yes, they have the funds to pay that kind of cash, but that is a huge wake up call to any of the other dipshit companies who try to pull this.
The settlement focused mainly on Pfizer's promotion of Bextra, an anti-inflammatory drug pulled from the market in 2005 for safety reasons. Source
I was on Bextra for a while after a neck injury when I was 17. It worked beautifully... but it wasn't designed for that use. I remember people coming in who were prescribed Bextra for migraines. That's when I found out what it was actually intended to be used for and it was the first time I heard the phrase 'off-label use'.
Plus you think they would learn after a while
Government attorneys noted this is actually the fourth settlement with Pfizer or one of its subsidiaries since 2002 over illegal marketing, but the fines for those cases totaled only $513 million. Source
So... you haven't learned eh? The biggest and bestest company in its industry in the world can't follow the rules? Sounds familiar...
Pfizer was also accused of fraudulently marketing the anti-psychotic drug Geodon, the antibiotic Zyvox, and the epilepsy treatment Lyrica. Source
The Lyrica one we have become aware of over the past year. Seems as if that is the drug of choice for damn near every condition as of late.
Have a cough? Take 50mg of Lyrica. Trouble growing flowers in your garden this year? Take 75mg of Lyrica.
The kicker is, as far as I can tell, this didn't even make a blip in the news media. Pfizer was effectively dickslapped by the government and the headline on CNN was about a 'John School' for prostitution offenders. Uh huh...
I really feel sorry for Pfizer's stockholders. They have virtually nothing in their drug pipeline for when all their blockbusters go off patent in the next 2-3 years and, I would assume, their planned deal with Wyeth is going to fall through now. I can't imagine Wyeth would allow themselves to be involved with such negative publicity, but then again standards in this country are quite low nowadays.
And that is why the Viagra is so sad in that picture above. Poor poor Viagra.
Wednesday, September 2, 2009
Retake Gen Chem I - Check! Passed with an A
Retake PCAT - Check! See here
Get Married - Check! See here
And finally, my nerdiest endeavor of the summer. I mentioned I was going to start back up doing some sim racing. Well I did end up picking up that wheel and pedal set I wanted
And I drove many different cars, Example 1, Example 2 and Example 3. And ended up the summer with a decent set of stats.
All in all it was a damn fine summer. Now it's time to finish those damned pharmacy school apps...